By Labour has today launched a consultation on new patient rights to be contained within the NHS Constitution. The various proposals include a new right to be treated within 18 weeks - or seen by a cancer specialist within a week - and an interim milestone of two weeks. It also proposes a new right to be offered an NHS Health Check every five years for everyone aged 40-74.
When Labour came to power in 1997 the NHS had been brought to its knees by 18 years of chronic under-funding by the Tories. Massive waiting lists for operations were commonplace, even for cancer patients.
Labour's consultation process outlines the next steps along the road to making further and significant improvements in the NHS with new patient rights including more convenient access to GP services.
Labour has fought hard to make things better for patients. We mustn’t allow the Conservatives to take us backwards, which is precisely what would happen if they won the next general election. David Cameron’s warm words about his love for the NHS are meaningless; he’s on record last year, for example, saying he thinks Labour’s NHS targets to cut cancer waiting times are wrong.
Let's just look at what the Tories actually did when they were last in power, compared with Labour’s record since 1997:
* Between 1979 and 1997 the number of people on NHS waiting lists went up by more than 400,000, but since Labour has been in power the number has fallen by almost 600,000.
* In 1997, 284,000 patients were waiting for over six month for treatment. Today, the NHS is delivering the shortest waits on record with the average wait for inpatient treatment running at 4.5 weeks. Waiting times in my city of Derby are among the lowest in the country.
* Two million more operations are carried out each year than in 1997 – including more than double the number of heart operations.
* More than 89,000 extra nurses and over 44,000 doctors have been recruited since 1997.
* There weren’t any NHS walk-in centres in 1997 – today there are 90 around the country including one in Derby.
Like motherhood and apple pie, the Tories say they would like to see waiting times go down, but in the next breath they say governments shouldn’t set mandates or tie the hands of the medical profession with top-down targets. This is further evidence that the Tories haven’t changed and the truth is that they cannot be trusted with the NHS.
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Just a few days ago we had a 4 hour wait for treatment whilst my 3 year old son was bleeding from a head wound. How nice it was on Friday night to watch police escorted drunks who had got into fights or fallen and hurt their legs getting treatment in front of a toddler oozing blood.
I've got more. A mixed ward for my meningitis suffering wife. The maternity department completely running out of Entonox and NOT REALISING IT FOR OVER 2 HOURS so that all the women were getting no pain relief during labour!
But the simple fact of the matter is negative anecdotes like these are worthless, just as worthless as positive anecdotes.
The figures shouldn't lie but I really don't think they can be trusted. I doubt the tory voters here believe the labour figures and I doubt the labour voters here trusted the tory figures. I don't think of myself as either and like I think most of the general public I don't trust the current figures either.
May I ask as a general question to those who seem appreciative of this article such as Richard, Peter and the author Chris as to their opinion on PFI and it's place in the NHS, and the long term viability of the off balance debts and special vehicles that have funded it?
What do you think of things like the fact that KPMG earned £5M in fees from the DoH for the first 6 months of the year (a 100% rise) and that the former Director General of Commissioning of the NHS has just joined KPMG as the Head of Healthcare, Europe & UK?
Do you think the government was right to buy £1.5B of operations from private health contractors? Each at price higher than the NHS equivalent and with payment guaranteed whether the operation happened or not?
And Chris what is it with the way you quote you figures?
etc etc up by 400,000 etc etc down by 600,000. Completely worthless figures unless we know the total numbers and whether or not the system of measurement has changed.
284,000 waiting more than 6 months.... average wait times for inpatient treatment now 4.5 weeks. Derby is really low... Apples & Oranges. Complete numeric disconnection between the "bad" bit and the "good" bit. You might of well of quoted the bad figure twice in different ways, we couldn't tell.
2 million more operations... Great, what percentage increase is that. Whats the percentage increase per surgeon. Whats the cost comparison? Are the operations cheaper or more expensive adjusting for inflation. Has the rise been efficient or innefficient? How many of these operations have been necessary due to poorer health in the general population? more obesity, asthma, alcohol abuse in the young?
Double the number of heart operations. From what to what? How many more forms of heart operation are there now compared to then? How many more are simpler operations like Angioplasty only approved for use in 2004 and which uses far fewer resources and can be done much more quickly?
X extra nurses, X extra doctors. Whats that in percentage terms? How much more is that than there would have been if the figures had continued the trend under the previous government? Whats happened to the cost of those resources on average? What are they doing? How efficiently are they doing it now compared to then?
90 walk in centres compared to none. Well that's an infinity% increase. Woo Hoo! But says nothing. Are they working? Are they providing services better than what used to do it? Are they an efficient use of resources? Who likes them? Who hates them? Who OWNS them and who staffs them? Who's getting rich off the backs of them?
It's just the picking of numbers which may have merit but which are then used in a completely vapid and worthless way. They say nothing about any improvements in the NHS whatsoever. It's probably not your fault directly because you probably just copied them off a pamphlet. But I've read science journalists with a better grasp of statistics.
so we changed the statistics on what 'on a list' meant and then the numbers fell!!
just like we left you lying in an ambulance at the door of Casualty so the clock for your 'time to treatment' didn't start start until we wheeled you in
then , because there were no beds, we redesignated a trolley in a corridor as a 'ward' and transferred you to the ward in new record times
and you cant book a GP appointment 3 weeks ahead becasue that will make their figures look bad and cost them money
and we all got bonuses for these great Labour achievements!!!! Pro-rata NHS managment is better than banking. All the rewards, no risk!!
No it's not. Look up the figures, they are all public.
One hospital near me has an annual turnover of half a billion and the chief executive earns £200K (eight times the national median salary). The figures are all public so you can check them yourself before posting.
But thanks for reminding us about the patients on trolleys in corridors that we had under the Tories - that was a bad memory I wanted to disappear.
And you say the figures are all public but you miss the major point. NHS Managers are fireproof. When was the last time a manager was dismissed for 'producing' good figures or sheer incompetence? There have been a few but not many and when they do go its often with a huge payout.
Oh yes and a few more bad memories you may have suppressed:
1 doctors pay up by around 40% and productivity falling
2 the shambles of Doctor Training which led to Patricia Hewitt leaving - oh and along the way she axed 17,000 jobs in the NHS but you don't mention that either
Oh forgive me, that must have been the fault of the Tory government of Tony Blair.
There are several issues here, I'll touch on a few. The first is their pledge to get rid of targets. This is naive at the extreme. Every organisation has metrics to measure quality control. My local hospital (I am an FT governor) treats national targets as minimum standards. However, they have more targets that they have set themselves and do not publish, and these are even more stringent. This is because they are serious about high quality healthcare. Abolishing targets is an invitation by a Tory government to lower standards. Lower standards are cheaper to achieve, and hence allow for cuts to be made.
Next, look at their frankly stupid idea of "value based pricing" for drugs. Why is this stupid? Two reasons: first, it will not work, and second, the example they give highlights the worst possible way to run healthcare.
They say: “we should encourage the NHS to use whichever medicines are clinically effective, and agree to pay the drugs companies according to the therapeutic benefit and innovative value.” Clinicians decide which drugs are effective, we do not need Cameron telling them what to use. But the last part of the sentence is interesting. How will they persuade a drug company to accept the payment that the NHS thinks is appropriate based on its “therapeutic benefit and innovative value”? As I said, this policy simply cannot work.
But now look at their example of how "value based pricing" should work. In their policy document (linked above) they use the Lucentis fiasco as an example.
Let me explain. Avastin is a bowel cancer drug (ie used in quantity) but patients with age related macular degeneration found their condition improved when they were treated for bowel cancer. Trials showed that a tiny injection of Avastin effectively halted “wet” ARMD. So the drug company altered the drug to remove the cancer active part and called it Lucentis. The drug company says openly that the cost of Lucentis was chosen not for the cost of production or development, but for what they thought people would pay to save their sight. Is this the sort of principle that we should encourage in the NHS? Cameron thinks so.
In clinical terms Avastin and Lucentis are *exactly* the same. The company applied, and got, a licence for Lucentis in the UK, but refused to apply for a licence for Avastin. Now the kicker: Lucentis costs 1000 times more than Avastin because they think people will pay that price to save their sight. A very Cameroon principle: encourage the private sector to fleece the needy.
NICE had to provide a treatment for wet-ARMD and they cannot approve unlicenced drugs, so they came up with this frankly ludicrous agreement that the NHS pays the first 14 treatments (at £1000 each) and the drug company pays for subsequent treatments. Most patients do not need all 14 treatments, very few patients need more than 14. So this is effectively paying the drug company what they want. It is not an agreement to be proud of. Note that if Avastin is used in this treatment, 14 treatments costs less than twenty quid, if Lucentis is used it costs the NHS £14,000. If the patient approves then Avastin can be used instead of Lucentis, NICE approval is only needed to recoup the cost, but as you can imagine £1 per treatment is effectively treated as being ‘free’.
The Tories say that this is the model that they want to see repeated in the future. I am aghast that they want to reward this blatant gouging by a drug company. But this is the sort of "private partnership" that the Tories will bring into the NHS.
Another policy of the Tories is "payment by outcome". They say that they plan that "payments follow the patient" but they ignore the fact that they do so already: Labour have given patients the right to choose, and hospitals are now funded by the badly named "payment by results" (PbR). PbR means that the hospital gets paid for each procedure they perform, so they get paid for actually doing the treatment. So the payment does follow the patient.
So what is Cameron planning to do? He is planning to link payment with the final outcome. Why is this important. Well, if payments are only made on the outcome then hospitals will be reluctant to perform any treatments that do not have a 100% outcome. Of course they won't - healthcare is costly and the hospital will need to be paid. So kiss your chance goodbye of getting a life-saving operation that does not have a 100% success rate. The Tories like this idea because life-saving operations are the more costly ones, so the fewer that are carried out by the NHS, the more that Osborne can cut from the NHS budget.
The current system, where hospitals are rewarded for the work they do is much better.
Currently, standards are held high by targets, high standards in the NHS mean less business for private healthcare, which leads to lower private costs as the private providers try to attract patients. But the private providers also try to bid for NHS work. Overall, targets are having a significant effect in the NHS and private healthcare. When you think about it, targets are the best thing for the NHS, and scrapping them will be the worst thing that can be done.
What a fine contribution ....
"In 1997, I and my family plus friends and colleagues all had NHS dentists. For a doctors appointment you simply phoned up and we were always seen that day. You did not pay to park in hospital car parks.
In 2009, Neither I nor any of my family, plus many of my friends and colleagues have access to a NHS dentist, they simply say that they are full up.
For a doctors appointment you must phone at exactly 0830hrs and then redial, redial and redial. You will eventually get through and be told that there are no appointments available and that you cannot make an appointment for another day, you must start the whole process again tomorrow!
I have to drive a friend to hospital regularly for treatment for her terminal cancer, it costs a minimum of £2 each visit!"
Roo Ster
Hands down! What an improvement!
As to GP appointments, well that is not typical and the government have taken steps to prevent it. But remember, a GP practice is a private business. When you criticise a GP practice for poor service then you are implicitly criticising private practice.
As to car parking, I am afraid that this is a consequence of the appalling internal market. You see, hospitals have to have a capital return on all its assets. If it has a ward or an operating theatre, then the capital return is clearly the money that they get paid for the patient. But tell me, when a hospital has to have a capital return on a car park, how do they do that?
Now tell me who brought in such a wrong headed way of running hospitals? It would be easy to get rid of car parking charges if the internal market was abolished and hospitals could concentrate on treating patients rather than this obnoxious idea that they are businesses making money.
When dentists are expected to see 45-50 patients a day to meet the target there is something wrong
Also, because working people have to pay in any case, often a private scheme can work out as good value for money. Longer appointments, better materials and a dentist not constantly watching the clock.
Not that it should be that way, obviously, but the problem is that dentistry has never been entirely integrated into the NHS.
But then the budget has doubled. Parts of it is now blighted by PFI and poorly built hospitals. GPs have seen a huge rise in salary and yet they work less. Much less.
My town has seen its hospital close and the NHS direct centre is now due to be moved out of town without a peep from the local Labour MP.
My wifes treatment during her pregnancy was appalling and although the service he got recently was superb my son ended up with an infection which led to great deal of pain following minor surgery in our local hospital.
So WOW lets slow handclap. Labour spent a SHED LOAD of my money on a healthcare system that is barely adequate. Big xxxxing deal. If you think that deserves some praise then think again.
ANY FOOL can spend other peoples money. Getting the very best out of any money spent is a skill. Something Labour never mastered.
Oh and why you socialists are cheering the NHS just remember that LABOUR has privatised huge swarths of it. Well done.
In any organisation or endeavour put together and managed by human beings, mistakes will occur. It is inevitable.
It is mindless to condemn a whole organisation for the mistakes that do occur in that organisation.
I would recommend that you never step on an aircraft, because as sure as eggs is eggs, the people in an airline occasionally make mistakes and an aircraft will go down - with tragic consequences.
On the other hand, in the event that you have the misfortune to be involved in a car accident, I have no doubt that moderately-paid men and women in the Police, Fire, Ambulance and NHS will do their utmost to give you the best care and attention that is available.
Now, why don't you finish reading today's copy of the Daily Mail, if you haven't already done so?
You are right - Labour's record regarding the NHS is a great achievement, probably unprecedented in the history of the NHS.
Time and again, I meet people when out door-knocking who cannot speak highly enough of the standard of care - both medical and pastoral - that they have received in our local (Foundation trust) hospital.
In addition (see Mortality Statistics 2007 on the ONS website), deaths from cancer and circulation-related diseases have continued to trend downwards.
The NHS is Labour's great success and has relieved an immeasurable amount of avoidable suffering.